Provider Demographics
NPI:1598858029
Name:TRAXLER HEALTHCARE INC.
Entity Type:Organization
Organization Name:TRAXLER HEALTHCARE INC.
Other - Org Name:TRAXLER CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:TRAXLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:318-323-8729
Mailing Address - Street 1:P.O. BOX 2537
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71207
Mailing Address - Country:US
Mailing Address - Phone:318-323-8729
Mailing Address - Fax:318-323-8867
Practice Address - Street 1:505 NORTH 18TH ST.
Practice Address - Street 2:SUITE B
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:318-323-8729
Practice Address - Fax:318-323-8867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1406111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CV16Medicare PIN